XML-based clinical data standardisation in the National Health Service Scotland

The description of the XML Steering Group in Scotland, as described in the paper by Raluca Bunduchi, refers to the state of play between 2000 and 2004. I would like to update readers on the present circumstances. The Steering Group has been disbanded as its main functions have now been superseded. It had developed and published standards for referrals, discharges and investigations. Now, in 2006, all main laboratory test results are reported back to all GP practices via the standard schema; approximately 70% of all referrals are sent electronically in Scotland,many protocol-based using the standard schema, with a target of 90% next year. Around 80% of GP practices can send and receive GP summary records when patients move practice. The success of these and other developments is one of the benefits of having strong clinical involvement in IM&T. The Steering Group also helped develop understanding of XML itself, with training workshops and conferences. Now XML is a routine technology for which there are plenty of ways for IT staff to gain knowledge. Finally, the business world has changed: interoperability between systems was relatively unknown in 2000, but now there is an expanding spaghetti of systems from different programs and suppliers communicating with each other. Developing new standards is not the main issue – managing change is. The Steering Group was disbanded in 2005 and replaced by an Interoperability Working Group comprising invited representatives from each of the main national systems suppliers and project sponsors. The role of the new group is to manage changes to standards affecting interoperability. Problems of interoperability which cannot be sorted amicably within the group are escalated to the financial and political levels. The philosophy of clinical involvement in developing data standards has matured and we now have a programme developing patient data standards for electronic health records: the National Clinical Datasets Development Programme.